Nursing Care Plan Impaired Physical Mobility

symptoms of multiple sclerosis 195x300 Nursing Care Plan Impaired  Physical  MobilityNursing Care Plan Impaired  Physical  Mobility Definition Limitation in independent, purposeful physical movement of the body or of one or more extremities,Postural instability during performance of routine activities of daily living (ADLs); limited ability to perform gross motor skills; limited ability to perform fine motor skills; uncoordinated or jerky movements; limited range of motion; difficulty turning; decreased reaction time; movement-induced shortness of breath; gait changes (e.g., decreased walking speed, difficulty initiating gait, small steps, shuffles feet, exaggerated lateral postural sway); engages in substitutions for movement (e.g., increased attention to other’s activity, controlling behavior, focus on preillness/predisability); slowed movement; movement-induced tremor, Nursing Care Plan Impaired  Physical  Mobility

Defining Characteristics

  • Gait changes, postural instability; difficulty turning
  • Limited ROM; ability to perform fine and gross motor skill
  • Movement-induced tremor, uncoordinated or jerky movements
  • Slowed and/or uncoordinated movements; reaction time.
  • Substitution of other behaviors for impaired mobility (for instance,increased attention to other’s activity and controlling behavior)

Related Factors

  • Activity intolerance
  • Decreased endurance; muscle
  • Altered cellular metabolism control, mass or strength
  • Body mass index above
  • Depressive mood state75th percentile
  • Deficient knowledge about
  • Cognitive impairment value of exercise
  • Contractures
  • Developmental delay
  • Cultural beliefs regarding
  • Discomfort age-appropriate activity
  • Disuse
  • Deconditioning
  • Joint stiffness

Assessment Focus

  • Activity/exercise
  • Neurocognition

Expected Outcomes The Patient Will

  • Maintain muscle strength and joint ROM.
  • Be free from complications (e.g., contractures, venous stasis,thrombus formation, skin breakdown, and hypostatic pneumonia).
  • Achieve the highest level of mobility (will transfer independently,will be wheelchair-independent, or will ambulate with assistive devices such as walker, cane, and braces).
  • Carry out mobility regimen.
  • Use resources to help maintain level of functioning.

Suggested Noc Outcomes

Ambulation; Ambulation: Wheelchair; Joint Movement: Hip; Joint Movement: Shoulder; Mobility; Transfer Performance

Interventions And Rationales

Determine:  Identify level of functioning using a functional mobility  scale. Communicate patient’s skill level to all staff members to pro-vide continuity and preserve identified level of independence.Monitor and record daily any evidence of immobility complications as they may be more prone to develop complications.229 Perform:  Perform ROM exercises to joints, unless contraindicated, at least once every shift to prevent joint contractures and muscular atrophy. Turn and reposition patient every 2 hr. Establish a turning schedule and post at bedside. Monitor frequency of turning to pre-vent skin breakdown by relieving pressure. Place joints in functional position. Use trochanter roll along the thigh, abduct thighs, use high-top sneakers, and pull a small pillow under patient’s head to maintain joints in a functional position and prevent musculoskeletal deformities.Place items within reach of the unaffected arm if patient has one-sided weakness or paralysis to promote patient’s independence.Carry out medical regimen to manage or prevent complications (e.g., administer prophylactic heparin for venous thrombosis). This promotes patient’s health and well-being.Provide progressive mobilization to the limits of patient’s condition (bed mobility to chair mobility to ambulation) to maintain muscle tone and prevent complications of immobility.Inform:  Instruct patient and family members in ROM exercises,transfers, skin inspection, and mobility regimen to help prepare for discharge and promote continuity of care. Request return demonstration to ensure use of proper technique.Attend:  Help patient use a trapeze and side rails to encourage inde-pendence in mobility. Instruct him to perform self-care activities to increase muscle tone.Encourage physical therapy sessions and support activities on the unit by using the same equipment and technique. Request written mobility plans for reference. Ensure all members of the healthcare team are reinforcing learned skills in the same manner.Manage:Refer patient to a physical therapist for development of mobility regimen to help rehabilitate musculoskeletal deficits Assist patient in identifying resources such as American Heart Association to provide a comprehensive approach to rehabilitation.

Suggested Nic Interventions

Exercise Promotion: Strength Training; Exercise Therapy: Joint Mobility; Exercise Therapy: Muscle Control; Positioning: Wheelchair

Referenc

Gillis, A., & MacDonald, B. (2005, June). Deconditioning in the hospitalized elderly. The Canadian Nurse, 101(6), 16–20.

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